Provider Demographics
NPI:1912703729
Name:DIXON, WARNELL (BT)
Entity type:Individual
Prefix:MR
First Name:WARNELL
Middle Name:
Last Name:DIXON
Suffix:
Gender:
Credentials:BT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:281 LIBERTY DR APT 265
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-7063
Mailing Address - Country:US
Mailing Address - Phone:910-803-8515
Mailing Address - Fax:
Practice Address - Street 1:1 OFFICE PARK DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-7326
Practice Address - Country:US
Practice Address - Phone:910-577-3207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician